Prophylactic cranial irradiation in patients with small cell lung cancer in The Netherlands: A population-based study

Clinical and Translational Radiation Oncology

Peter S.N. van Rossum¹  Anne van Lindert²  Dirk K.M. De Ruysscher³  Max Peters⁴  Mathijs L. Tomassen⁴  Joost J.C. Verhoeff⁴  Mieke J. Aarts⁵ 

[1] Corresponding authors.;Department of Pulmonology, University Medical Center Utrecht, The Netherlands;Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands;Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands;Netherlands Cancer Registry, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands;

关键词: Small cell lung cancer;    Prophylactic cranial irradiation;    Population-based;    Survey;    MRI;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction: Controversy has arisen regarding the benefit of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC), particularly since the 2017 Takahashi trial publication that supports MRI surveillance in extensive-stage (ES-)SCLC. The primary aim of this study was to assess trends and determinants in PCI use over the years 2010–2018. A secondary aim was to determine contemporary practice considerations among radiation oncologists (ROs). Methods: A nationwide population-based cohort study was conducted using the Netherlands Cancer Registry data on all newly diagnosed SCLC patients (2010–2018). The change in PCI frequency over the years and determinants for PCI were analyzed using logistic regression models. Second, an online survey was performed among Dutch lung cancer ROs in 2020. Results: Among 10,264 eligible patients, 4,894 (47%) received PCI. Compared to 2010–2014, PCI use significantly decreased in 2017–2018 in ES-SCLC (OR 0.68, 95%CI 0.60–0.77) and LS-SCLC (OR 0.56, 95%CI 0.47–0.67). Incidence year, age, performance status, and thoracic radiotherapy were independent determinants for PCI. Among 41 survey participants, PCI was recommended always/sometimes/never by 22%/71%/7% in ES-SCLC and 54%/44%/2% in LS-SCLC. For ES-SCLC and LS-SCLC, 63% and 25% of ROs, respectively, confirmed influence of the Takahashi trial on PCI recommendations. Denial of such influence was associated with insufficient institutional MRI capacity. Conclusions: A significant declining trend of PCI use in both ES-SCLC and LS-SCLC was observed in The Netherlands since 2017. The Takahashi trial seems an explanation for this trend even in LS-SCLC, with differential influence of the trial depending on institutional MRI capacity. An alarming increase in practice variation regarding PCI was found which stresses the importance of ongoing trials.

【 授权许可】

Unknown